"Late running of outpatient clinics"

About: Hairmyres Hospital / General Medicine

(as the patient),

I only see a rheumatologist twice annually unless there is a situation that required urgent attention. That has happened in the past & I was very grateful that my needs were accommodated.

However, I can't remember an instance in the last two years when I have attended for x-ray, investigative procedure or particularly outpatients, when I have been seen at the appointed time. Everyone knows there can be unforeseen circumstance & that it could be me that causes the schedule to overrun.

The crux of the matter appears to be that the time allotted for each appointment is way to low.

Waits of anything up to 3 hours. Personal I've had a 3. 15 appointment in the Gastro clinic & wasn't seen till almost 5 pm.

Today I turned up in plenty of time for a 9. 40 appointment that had already been moved to 10 am. It got to 10. 15 when the announcement was made that the clinic was running 40 minutes late. I decided not to wait, that'll hopefully make it a shorter wait for people who have perhaps had to take unpaid time off work to attend. Who knows other peoples situation, the thing is, does anyone care?

OK I'm having to wait till next June for another appointment, but you what, I'm past caring.

I should also add that when I rang my secretary for the consultant to ensure that my records were not marked as ‘No Show’, as had happened previously, I was offered an appointment with another person whom I’d never heard of. I explained that I would prefer to see the same person in the interests of continuity, I was told that that is not the way it works. The best folk are shared across all patient seemingly. That makes no sense at all to me, particularly as I had a very bad experience after seeing a Trainee on one occasion & he prescribed a cocktail of 3 drugs that gave me 5 weeks of GI tract hell.

Continuity of treatment is of paramount importance to me.

An update - would you believe I'm back in Out patients, orthopaedics this time. This appointment, which I think I've waited 12 weeks for, was made by phone on the last date that would hit that 12 week deadline.

It was for 11:15 in mid December. Here I sit some 90 minutes past the appointed time, trying desperately to control my annoyance. I appreciate that a) this is an additional clinic presumably to help clear a backlog b) the expense of the consultants time dictates that they need a ready stream of patients. However, allocating 10 minutes for each person is absolute madness. I've estimated that each patient is taking 45-60 minutes.

Would it not therefore be sensible to allocate 20mins/patient? That would ensure enough patients were available & cut waiting times by half.

No show data that is held up to shame the people who have scant regard for the service us deserved. To balance that how about publishing waiting times?

Surely there is a better way to do it. Some of these nurses appear to stand about for hours on end & appear to do only short tasks for each patient, i.e. weight & take BP, could they be recruited to do a work-study of actual consulting times. That way a realistic average could be arrived at.

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Response from Michelle Nobes, Patient Affairs Manager, Hairmyres Hospital, NHS Lanarkshire

picture of Michelle Nobes

Dear Madge51

Thank you for your comments and I am very sorry indeed to read about all the problems you have had whilst attending your outpatient appointments.

This is clearly unacceptable and please accept my most sincere apologies.

However, what are we going to do about it to improve the situation for yourself and others in the future? This is a difficult question for me to answer straight away as there are a set of very complex, inter-related issues at play in all of this. However, I can say that I will ask for a report from the relevant Heads of Department responsible for the delivery of these specific clinics to obtain data on how they are running, the number of patients booked, the time slots for each new and return patient, and the “performance” of the clinic in terms of appointment time and actual time seen etc.

I will then use this information to identify potential changes which can, hopefully, capture the patient experience for everyone attending the clinics.

I am sorry I cannot be more specific at the moment but I can assure you that I will look in to this as described above. Please accept my apologies for this dissatisfactory experience in the meantime.


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Update posted by Madge51 (the patient)

That's brilliant Michelle,

I always try to make feedback constructive particularly in a situation that I could see from the outset, was complex. How do you ensure that steady stream of people to be seen v what happens if there's a 'no-show'. It would be interesting to have the 'No show' data upfront since I suspect that the telephone reminder service has gone a long way to reducing if not eradicating this problem.

What do the consultants think? An old-fashioned work-study analysis would provide good raw data perhaps.


Response from Michelle Nobes, Patient Affairs Manager, Hairmyres Hospital, NHS Lanarkshire

picture of Michelle Nobes

Hi Madge51

I didn’t think that there were many of us left that would remember the work study days!!

It is exactly this type of thing that we actually need to do.

We do keep track of the Did Not Attends (DNA’s) and we try and “add on” a few patients in anticipation of the average DNA number for that clinic – sometimes it works and sometimes it doesn’t.

Different time slots are given for “new” as opposed to return patients and that informs the clinic schedule. In some cases we are also trying to eliminate or reduce long term “return” appointments and simply say to the patient (and/or GP) to contact the hospital if they feel they need to rather than book them in.

All of those issues will be collected along with the data! I do hope you will see improvements when you return.

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